COLLEGE COUNSELOR REGISTRATION FORM

9/10/19 Update: While MACN continues to accept late registrations, the table layout has now been set. Colleges that register at this late date will have a table at the end of the alphabetical arrangement, and will not be in order by school name.

* Please use Google Chrome when completing the online registration to avoid error messages that appear when using Internet Explorer and other web browsers.*

Please note our event cancellation policy: Refunds, minus a $25 processing fee, will be made if the request is sent via e-mail to memphiscollegenight@gmail.com by Monday, August 26, 2019. Refunds will not be given for cancellations made after August 26 or in the event a registrant simply does not show. 

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Please indicate the number of tables you want to register for.
Name of Representative # 1 (Primary Contact) *
Name of Representative # 1 (Primary Contact)
Representative #1 Telephone Number *
Representative #1 Telephone Number
Name of Representative #2 (If applicable)
Name of Representative #2 (If applicable)
If more than 2, additional dinner tickets may be purchased for $15 each.
Mailing Address for Registration Confirmation *
Mailing Address for Registration Confirmation

WHEN: 9.16.19 // 6-8 PM

WHERE: AGRICENTER INTERNATIONAL

7777 Walnut Grove Road
Memphis, TN 38120

memphiscollegenight@gmail.com

FUTURE MACN DATES:

  • 9.21.20

  • 9.20.21

  • 9.19.22